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Special evaluations can help seniors cope with cancer care



Nancy Simpson had her first breast cancer treatment, count backward from 20 and repeat a silly phrase.

It's all part of a special patient's test starting to catch on among cancer doctors. Specialists call these tests for geriatric assessments mental fitness, along with emotional and social well-being.

To avid walker with a strong network of nearby family and friends, Simpson, now 80, says she "wanted to do the maximum I could handle "to fight her disease.

"It gave me encouragement. Then I felt like I am OK and I can get through this and want to get through this," said Simpson, who lives in Fairport, New York, near Rochester.

These tests have been recently recommended for cancer. In new guidelines, the American Society of Clinical Oncology recommends the evaluations for patients aged 65 and up, especially before making decisions about chemotherapy.

For example, in the case of chemotherapy might worsen, patients might be offered physical therapy first. Relatives or friends might be preparing for a meal or have a meal. And for those who want to avoid the hospital no matter what, treatment that could have put them there would have been avoided.

Almost 1

million U.S. adults aged 65 and older will be diagnosed with cancer this year, the American Cancer Society estimates. Nearly two-thirds of all cancer patients are in that age group. And yet, most cancer treatments stem from studies on younger, often healthier patients. That leaves doctors with limited information on how treatments will affect elderly patients. Geriatric assessments can help bridge that Supriya Mohile, a specialist in geriatric cancer at the University of Rochester Medical Center.

These tests may require 15 to 30 minutes or more and recent research, Mohile said ,

"We hear all the time about 'decision regret," she said

Mohile co-authored a recent study that found just 1 in 4 US cancer specialists did the assessments. She said doctors say it takes too long and that patients do not want it. But you hears from patients and caregivers: "I'm so happy you're asking me about these things."

One of Mohile's colleagues did Simpson's evaluation, which showed she was strong enough to endure a standard, aggressive three-drug chemotherapy combo for breast cancer.

The evaluation showed "I was not in as bad as my age would indicate," Simpson said.

Her walking buddy and four

Treatment left: Simpson with hair loss, fatigue and excruciating mouth sores.

Cancer "gave me a different perspective on what is important in life and what is not and I'm still adjusting to that," Simpson said.

Dr. Hyman Must, a geriatrics specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center says there's no question about the evaluation. Medicare wants to pay for yearly physical exams but not geriatric assessments, he said.

Advocates note that the patients can fill out at the doctor's office.

Beverly Canin, 84, of Rhinebeck, New York, became an advocate after declining chemotherapy following surgery for early breast cancer 20 years ago.

A 2015 medical report Canin co-authored a patient who had the opposite experience. The 92-year-old man with rectal cancer is admitted. The doctor would not tolerate rigorous chemotherapy and radiation because of his advanced age.

The patient managed well and what cancer-free two years later.

"We are more precise treatment," she said.

"The risks associated with aging adults traditionally are overtreatment and undertreatment." —

Follow AP Medical Writer Lindsey Tanner on Twitter at @LindseyTanner.

The Associated Press's Health & Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.


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